Assessment of toxicity associated with inhalation of potentially toxic elements present in combustible tobacco products: cigars, pipe tobacco, bidis and cigarettes - An evaluation of risk assessment issues

Smoking-related diseases represent a substantial global health challenge, particularly given the direct inhalation of smoke into the vulnerable respiratory system. This method of consumption presents a challenge in classifying smoking in terms of exposure to toxins, in comparison to other forms of environmental contamination, such as food or air pollution. Combustible tobacco products (CTPs), including cigars, pipe tobaccos, bidis, and cigarettes, are therefore among the most toxic materials with a wide range of adverse health effects. The majority of studies on toxic elements in CTPs concentrate on cigarettes, with other forms of tobacco receiving comparatively little attention. Furthermore, there is currently no established methodology for estimating consumer exposure to these elements regarding smoke inhalation. The aim of this study was to estimate the exposure of consumers to potentially toxic elements (PTEs) in various CTPs, utilising a model adapted from food chemistry but considering air pollution exposure levels and the distinctive characteristics of smoking. The findings indicate that the inhalation of smoke from less than 0.5 g of tobacco can deliver hazardous doses of elements, such as Ni (non- cancer risk) or As (carcinogenic risk). This suggests that inhalation of toxic elements in cigarette smoke significantly contributes to tobacco-related health risks. Statement of Environmental Implication: 1. The analyzed tobacco and the determined potentially toxic elements themselves are contaminating materials and compounds as they have hazardous effects on the environment and humans. 2. The results of the study represent environmentally relevant conditions, as the analysis was made on real tobacco product samples and the calculations were appropriately modelled to estimate actual human exposure conditions.